This revised application, incorporating suggestions from previous favorable reviews, integrates innovative with well tested methods for cigarette smoking prevention among Latino middle school students. Building on the Latin American tradition of community health advisors, and the importance of family, we will recruit and train Latino high school students in large urban high schools to communicate to middle school students about dangers of tobacco and ways to prevent peer and other pressure to smoke. Rather than conducting their interventions in large
classrooms, these high school advisors (HSA5) will instead recruit families from neighborhoods near their schools who have a child of middle school age. They will meet with the middle school students and their families on six occasions to a) review health facts about dangers of tobacco, b) describe marketing approaches to minorities and legal issues related to tobacco purchases by minors; c) discuss peer pressure to smoke and role play refusal behaviors; and d) promote family communication about health related behaviors and encourage parents and other
family members to support their middle-school aged relative in remaining smoke free. Intervention materials (low literacy print materials and videotapes) will be 'user friendly' and minimize the expertise required of the HSAs. Approximately 100 advisors each year (300 total), 34 from each school site, will be recruited and randomly assigned either to the smoking prevention, or a no intervention control condition. HSAs will work in pairs with each pair recruiting at least 10 families who are not related to them (1500 total) to participate in the study. Five of the
families will be randomly assigned to the intervention and five to the no intervention condition after the recruitment period. Outcome measures of middle school children will include lifetime tobacco experimentation, susceptibility to smoking, and past 30-day use. The differential rates of acculturation between parents and middle school children and the potential buffering effect of HSA5 against negative life events experienced by the participants will be related to program outcomes.
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